Dear GQ doc. I can’t seem to be able to sleep as well as I once did. It’s beginning to annoy me that people keep saying I look tired. Is there anything I can do to make this better or perhaps things I should be avoiding? George, via email

A: You’re not alone, George. The desolation of our sleep is an escalating, problematic by-product of modern life and perhaps strengthened by its normalisation, we accept tiredness. Indeed, the national average of six hours or less each night sees us fall at the final hurdle, short of the recommended seven to nine hours the National Sleep Foundation aspire us all to.

The first thing we need to clarify is what you mean by your sleep issue. You see, sleep is a dynamic process, so is it that you cannot get to sleep (worrisome thinking, over-stimulated), are waking from sleep in the night (full bladder) or are waking up too early (a sign of worry or low mood)? These are questions that can light up the issue like a tracer round over a target. It is, however, also not that uncommon that you may give me confirmatory nods to all three questions.

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Now, however you clarify your sleep, the reasons for your sleep disruption can be divided into internal and external factors. The internal factors focus on issues with which you have little control: illness, distressing and ongoing life events, or recent long-haul travel which has confused your circadian rhythm and thus, your sleep-wake cycle. It may be, however, that none of those are bothersome, and that you have been investing all your time and efforts in the more popular external disruptive factors.

These commonly manifest as drinking too much fluid just before bed and, if you are a man maturing beyond the age of 50, this then works in collusion with your enlarging prostate dutifully waking you multiple times a night to urinate. The consumption of coffee and exercise, including sex (no matter how short a time frame) with your other half (or, yes, with yourself) will all serve as a stimulant to ensure getting to sleep is an uphill struggle.

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You may not have finished hauling your sleep over the coals just yet. If you enjoy looking at your smartphone in bed, you're allowing its emitting blue light to slowly switch off your melatonin, and your ability to sleep will be disrupted as well. The abuse to invaluable sleep can of course continue if you have a late-night snack or meal with a few beers. The food will increase your risk of heartburn as you lie flat, and the alcohol is both a diuretic and sleep-cycle anarchist, so you’ll wake up in the night – and then realise you need to urinate. Daytime naps are a bonding action to assure poorer sleep later that night. Then again, this isn’t the Mediterranean, so it’s unlikely your job affords you such luxuries.

Ultimately, the solution to poor sleep is a stepwise act to addressing both the external and internal factors that conspire to disrupt. As would many of us, you should start with conservative measures first, and, if needed, then progress to pharmacological measures via your GP. Sleep hygiene (see the table below) includes a set of principles that distil the majority of these conservative measures required to grease the wheels for your optimal sleep environment.

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8. Avoid having a television in the bedroom.

9. Make you bedroom a peaceful, tidy environment.

10. Again – mobile phone off. Get yourself another alarm.

11. Manage your fluid balance (nocturnal waking to use the bathroom is common).

12. Avoid sleep medication as first measure.

13. Avoid or deal with excessive thinking, worrying or planning.

Of course, everyone will inherit different internal and external factors which will need to be addressed. If there is a stress, you may benefit from taking positive action on it, or consider talking therapy; if there is uncontrolled pain, see your GP for optimisation of pain relief; or if travelling abroad, plan ahead how to coordinate your sleep pattern. If you find that despite the remodelling of your evening routine with these sleep hygiene principles your sleep continues to prove elusive, then you may benefit from a short course of sleep-promoting medication to help resynchronise your sleep pattern. These range from the herbal to the hypnotics. My trick: read a few chapters of a good book.

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It’s clear that modern society accepts chronic poorer-sleep quality and quantity as the status quo. Looking tired is not the badge of honour of a busy lifestyle. Reject this, and instead work towards welcoming a tide of better wakefulness, psychomotor performance and mood that go hand in hand with a good night of sleep. You will in the process be concomitantly minimising the insidious and chronic effects of sleep deprivation that includes an elevated risk of developing diabetes.

If, however, you have a baby, I am sorry but all the sleeping tablets in the world won’t help you. Good luck.

Dr Nick Knight is a GP registrar with a special interest in sports, exercise and lifestyle medicine. Follow him on Twitter @DrNickKnight and Instagram DoctorNickKnight